Menopause, Exercise and Physio

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Whilst menopause comes with many (not so pleasant) symptoms, the great news is that you can help manage many of them with exercise.
Exercise has many benefits post menopause including maintaining and improving:
• Muscle strength
• Bone density
• Mobility
• Joint flexibility
• Posture
• Balance
• Mood and general wellbeing

There are many different types of exercise so you should choose something that you enjoy, fits in with your lifestyle and helps manage your individual symptoms.

Types of exercise:

Aerobic exercise: This type of exercise works your heart and lungs, and is also important to prevent or manage heart disease, high blood pressure, high cholesterol and high blood sugar. This is any exercise that gets you huffing and puffing including activities such as cycling, swimming, tennis and gardening. It is important to avoid high impact activities such as running and jumping to protect your joints and pelvic floor as these are weaker post menopause.

Flexibility: Stretching and gentle respective movements increase the length of your muscles, resulting in improvement in your range of joint movement. Yoga is a great form of exercise to achieve this.

Resistance/Strength Training: This exercise uses weights, exercise bands, or body weight to help strengthen your bones and muscles whilst also improving your balance and coordination.

Functional Training (Clinical Pilates): Training your pelvic floor muscles to contract and relax as needed assists you to regain or prevent incontinence and prevent prolapse symptoms. This functional training is best done with an individualised exercise program that is designed to suit your individual needs. These exercises also enhance any strength training program and assist in flexibility or balance.
At SquareOne we use Clinical Pilates equipment to rehabilitate the function of pelvic floor muscles and deep abdominals, so that they automatically work during everyday activities. Clinical Pilates combines with a specific home exercise program will assist in achieving optimal function more quickly.

What can a Women’s Health Physiotherapist do for you menopausal symptoms?
A Women’s Health Physiotherapist can assess you individually and tailor an exercise program to address any particular issues and goals that you may have.
At Mosman Women’s Health, our physiotherapists have extra training in managing older women and in particular exercise prescription for the different needs of the menopausal woman.


The rest of this article explores:
• What exercise can help manage
•How much and what exercise you should do
• Who can help you (apart from yourself and a Physio)
• Some frequently asked questions

Exercise can be prescribed to manage:
1. Lowered mood and depression: This is significantly improved with exercise. Even as little as 30 minutes walking three times per week has been shown to decrease symptoms of depression. Exercise can also improve the quality of your sleep which helps you have more energy and feel less fatigued.
2. Muscle joint aches and pains: Specific exercise can improve muscle strength and control around joints to ease load and reduce pain. Exercise can reduce pain even when arthritis is present.
b After a comprehensive assessment, specific pelvic floor muscle training can be prescribed to address your symptoms. Exercises may aim to strengthen and bulk muscles, improve muscle relaxation and train your bladder if urgency is an issue.
4. Weight gain: A combination exercise program of high intensity interval training and weight training has been found to best prevent weight gain and assist weight loss. Interval training is aerobic training that has fluctuations in intensity. So there can be periods of harder work followed by easier work. Your physiotherapist can prescribe a program using your preferred exercise and taking into consideration any joint or muscle issues.
5. Cardiovascular problems: Exercise not only helps maintain a healthy weight, but also assists in lowering blood pressure and normalising cholesterol and blood sugar levels. This then reduces your risk of having a heart attack.
6. Bone density: Exercise causes stresses across the bone matrix resulting in increases bone density to cope with the load. After menopause resistance training using weights, exercise bands and body weight is the safest way to build bones whilst protecting your pelvic floor.
7. Loss of muscle bulk and strength: The same decline in muscles happens as with bones. If specific exercise is not started or continued at menopause, a significant reduction in strength and bulk can occur at this time. Muscle strengthening using resistance such as weights can improve your strength, balance and overall function.

How much and what exercise should I do?
Aerobic exercise:
For results you should do at least 20 minutes of this sort of exercise 3 times per week. ( Aim for 5 sessions). To be effective, you must work your heart and lungs so that you more heavily and quickly than when resting. You should be puffing, but still able to speak in sentences. Aerobic exercise should be avoided close to bed time to decrease the risk of overnight hot flushes.
Flexibility exercises:
These can be incorporated into the end of a cardio or resistance training work out or you may prefer to take part a group class such as yoga. These exercises are a great way to wind down at the end of the day and assist with sleep.
Resistance or strength training:
Resistance training is essential post menopause for bone health, maintaining good balance and weight management. This will need to be done 2-3 per week. To achieve the best results and to avoid injury, your program should be designed and monitored by a women’s health physiotherapist such as our experienced physiotherapists at SquareOne Physio.
Functional Training (Clinical Pilates):
Enrol in a Clinical Pilates class. This is ideally done weekly and should be supervised by a Women’s Health physio such as those at SquareOne.

What will happen at the first physio session?
The physio at SquareOne can assist you in commencing an exercise program even if you have never exercises before.
In your initial appointment your physio will discuss your health and medical history including any injuries you may have. Together you can set individual goals to meet your needs and address any menopausal symptoms.
Who can help?
1. You: You are the person who can change your diet, train your muscles, and reduce your risk of falls. You can organise a review with your GP and ask for a DEXA scan for your bone density.
2. Make an appointment with a Women’s Health Physio to design a program specific for you and your goals. A referral is not needed to see a physio. Your treatment may involve specific exercises and advice.
3. GP: Your local doctor knows you well. They can discuss any distressing symptoms with you and prescribe appropriate medication if required. They can refer you for a bone density svan and advise you to see a physio or specialist as required.
4. Endocrinologist: These specialists can prescribe appropriate medication to assist with menopausal symptoms and assist in preventing bone loss.
5. Family members and friends: our family and friends can be invaluable supports, especially in motivation you to keep exercising and changing your diet.
6. A Dietician: A dietician can advise you on dietary changes to ensure you have calcium intake and appropriate nutrition to prevent any unwanted weight gain.

Frequently asked questions:
1. Where do I find a Women’ss Health Physio?
SquareOne Physio
2. Do I need a medical check before I start?
If you have not been exercising regularly or do have particular health concerns, a GP check up is advisable before commencing any exercise program.
3. What if I have sore knees?
When you are assessed by an experienced Women’s Health Physio such as at SquareOne, we will tailor your program to prevent pain and injury whilst addressing your problems. Exercises to strengthen your muscles can assist in reducing pain you are experiencing.
4. If I have continence problem or prolapsed problem, can I still exercise?
It is best to have an assessment with a Women’s Health Physio prior to starting any new exercise routines, particularly if you are considering high-impact options.
5. Should I jog?
Generally if you have continence or prolapsed issues, you should avoid high-impact exercise (e.g running, jumping etc) and choose weights exercises instead. You can discuss your individual situation with your physio in your initial assessment.
6. If I lift weights, will I get bigger, manly muscles?
Women do have the same hormones as men and therefore will not develop muscles at the same rate. Weight training will assist in improving muscle tone but will not make you bulky.

Mosman Women’s Health are experienced with helping women deal with menopause and the challenges it may present. Book an appointment online or call 9968 3424 to discuss how we can help you.


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